We examined the effect of face masks for the Glutaral. First, in order to find out how face masks were applied in disinfection work, we conducted questionnaire survey at 45 medical facilities in Wakayama prefecture. As the result, we found that the face mask wearing rate was 51.6% and 68.8% of them wear disposable surgical masks. Next, in order to examine the effect of face masks, we conducted a service life test and an exhalation resistance test under The National Approval Test of Japan, using several kinds of face masks. As the result of the service life test, the environmental concentration of AG (0.05 ppm or less) set by Ministry of Health, Labor and Welfare was maintained for approximately 172 hours by a G-7 type gas protection mask (G-7: koken), 33 hours by a Muskie-51 (MS-51: koken) deodorant mask, and 50 minutes by the a Keymate-E200 (KM-E200: kurare) deodorant mask. However, the effect of the surgical mask could not be verified. As the result of the exhalation resistance test, G-7 indicated a higher point of the air-flow resistance (80 Pa). Yet, MS-51, KM-E200, and the surgical masks indicated lower points of it (13 Pa, 11 Pa, and 5 Pa, respectively), showing higher air permeability. Furthermore, we conducted a man-test to examine how well face masks fit. As the result of the man-test, MS-51 had the best fitting.
From the above findings, it was found that a mask made of activated charcoal fibers which has 3-D face-contacting cushion fits curved lines of face, and can be easily used. It also has superior fitting and strong protective ability against GA.

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The relation between urethral catheter (UTC)-related urinary tract infection (CRUTI) and duration of indwelling catheter was studied in CRUTI surveillance from May 2000 to December 2005 at the general ward of our hospital. Number of urethral catheters indwelt during whole surveillance period was 889, of which 45 UTCs were judged to be infected according to the diagnostic criteria of CDC for UTI and total device days were 7159. The infection rate of the whole surveillance period was 6.29.
The infection rate of patients with UTC indwelt for less than 5 days, from 6 to 10 days, from 11 to 30 days or over 30 days was 2.73, 3.56, 8.35 or 8.47, respectively. The infection rates of patients with UTC indwelt for more and less than 3, 5, 7, 10, 14, 17 or 20 days were 0.00; 7.04, 2.73; 7.20, 2.81; 7.77, 3, 14; 8.39, 4.22; 8.33, 5.69; 7.14 or 5.50; 7.83, respectively. Statistical significant differences of infection rate were found between the patients with UTC indwelt for more and less than 7 (p = 0.0151), 10 (p = 0.0059) or 14 days (p = 0.0277).
The infection rate of the patients with positive urine culture on UTC insertion was 18.69 and was significantly higher than the one (7.07) of the patients with negative urine culture (p = 0.0074).
These results revealed that duration of indwelling UTC must be limited to less than 14 days in order to reduce CRUTI as far as possible.

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Infection control of influenza is significant, because influenza is a common nosocomial infection. Surveillance of influenza virus infection was maintained on all wards of Fukuroi Municipal Hospital during the winters of 2002/2003, 2003/2004 and 2004/2005. During these three seasons, 50 patients had been diagnosed as having influenza during hospitalization. Among these 50 patients, 37 patients had been diagnosed as having nosocomial influenza. The incidence of nosocomial influenza was 0.02 per 100 hospital admissions. The sources of infection were estimated in 11 (30%) of the 37 nosocomial influenza patients. In the remaining 26 patients (70%), there was no clear route of infection.
Of 162 patients who were exposed to the influenza virus by being in the same sickroom with influenza patients, 78 patients had received preventive internal medicine, and did not develop influenza infection. Among the other 84 patients who had not received preventive internal medicine, the two patients developed influenza infection. To decrease the incidence of nosocomial influenza, these findings suggest that the reductions of exposure to influenza and practical preventive measures as well as medical attention after exposure are required.

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Surveillance of surgical site infection (SSI) in patients undergoing cardiovascular surgery has been continued since June 1999. The effects of modified preparations for surgery were investigated to reduce SSI. Bathing methods were assessed beforecardiovascular surgery. Patients have taken a shower and scrub using povidone iodine since October 2000. The incidence of SSI was dramatically reduced from 9.5% to 4.8% after adoption of this disinfectant shower scrub the day before operation. The incidence was further reduced to 3.7% if the shower-scrub was taken just before surgery (P=0.034). Preoperative shower and scrub using disinfectant on the day of operation is effective to reduce SSI.

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Risk factor surveillance was used to identify patients at high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection among 1005 hospitalized patients treated in the internal medicine wards of Koto Hospital, Tokyo, Japan from October 2002 to January 2006. MRSA was detected in 153 of the 1005 patients (15.2%). MRSAwas found in 8.6% of patients aged under 59 years, but in a significantly higher 21.6% of patients aged over 80 years. Detection rates by risk category varied from 0% to 37.5%. Patients in the three risk categories of central intravenous catheter, administration of antimicrobial agents, and urinary catheter had significantly higher rates of detection of MRSA among risk categories containing over 100 patients. 107 of the 153 patients with MRSA had received administration of antimicrobial agents. In particular, patients who received penem or penicillin antibiotics tended to show high rates of MRSA infection. Patients with several risk factors had high rates of MRSA infection. Patients without MRSA infections had a mean of 1.54 factors, whereas patients with MRSA had a mean of 2.46 factors. These results indicate that the infection control team (ICT) must increase monitoring of patients aged over 80 years old, with central intravenous catheter, urinary catheter, administration of antimicrobial agents, or more than one risk factor, who have a high risk for MRSA infection.

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The antiseptic effect of MR02B2 (0.5 w/v% chlorhexidine gluconate (CHG) /ethanol preparation) for hand antisepsis in healthcare workers wasevaluated compared to WU (0.2 w/v% CHG/ethanol preparation: Wellup) by the glove juice test. The log10 reduction factors (RFs) immediately after disinfection were 1.801 ± 0.938 in the MR02B2 group and 1.688 ± 0.906 in the WU group, showing adequate disinfection with no significant difference between the two groups. The log10 RFs 6 hours after disinfection were 1.598±1.078 in the MR02B2 group and 0.955±0.784 in the WU group. MR02B2 was significantly more effective than WU for disinfection at 6 hours (p < 0.0001). Bacillus sp. was most prevalent in the MR02B2 and WU groups after disinfection. MR02B2 exhibits equivalent disinfection efficacy to WU immediately after hand antisepsis, and more sustained efficacy than WU. MR02B2 is useful for hand antisepsis in both hospital wards and during surgical procedures, for which sustained disinfection efficacy is required.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The skills regarding prevention of the nosocomial infection are essential for medical students to attend the clinical clerkship. These skills are included as a part of the surgical skills in the objective-structured clinical examination (OSCE) conducted by the Common Achievement Tests Organization (CATO) of Japan. However, the number of medial schools where students' skills of infection control are tested in the OSCE remains quite small. In this study, we examined the frequency of the essential clinical skills experienced by medial students in the clinical clerkship. The degree of importance of each clinical skill was also asked. A written questionnaire was used to collect the answers from medical students who had completed the core clinical clerkship in the Tohoku University, School of Medicine during the academic year of 2004 and the teaching doctors of Tohoku University Hospital. The importance of infection control in the clinical clerkship was recognized by more number of clinical educators and medical students than the number who recognized other surgical skills important. Since not only knowledge but also actual skills are vital in the prevention of nosocomial infection, it is necessary to entail the skills of infection control including hand hygiene in the preclinical education of medical students. The OSCE should be used more widely among medical schools in Japan to check student' skills of infection control.

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[in Japanese]

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